中国癌症杂志
中國癌癥雜誌
중국암증잡지
CHINA ONCOLOGY
2013年
9期
733-736
,共4页
黄英杰%李昌水%葛荣%刘创峰%王德尚
黃英傑%李昌水%葛榮%劉創峰%王德尚
황영걸%리창수%갈영%류창봉%왕덕상
肾脏集合管癌%免疫组化%病理诊断%鉴别诊断
腎髒集閤管癌%免疫組化%病理診斷%鑒彆診斷
신장집합관암%면역조화%병리진단%감별진단
Collecting duct carcinomas of the kidney%Immunohistochemistry%Pathologic diagnosis%Differential diagnosis
背景与目的：肾脏集合管癌少见，不足肾脏恶性肿瘤的1%，肿瘤侵袭性强，超过50%的患者在首次诊断时已经发生转移。集合管癌的诊断常很困难，往往需要排除性诊断。本研究观察肾脏集合管癌的临床病理学特点、免疫组化特征，探讨其病理诊断及鉴别诊断。方法：收集5例肾脏集合管癌的患者资料，进行病理组织学观察，免疫组织化学染色(EnVision法)检测CK19、CAM5.2、CK7、Vimentin、CD10、P63和PaX-8。结果：肾脏集合管癌临床症状以血尿、腹痛、腹块为主；肿瘤主要起源于肾脏中央区的髓质，组织学以不规则的腺管状或管状乳头状结构，伴炎性纤维组织增生性间质为主要形态学表现；免疫组化检测结果显示，5例肾脏集合管患者中，CK19、CAM5.2、PaX-8均为阳性表达，2例Vimentin存在阳性表达、1例CK7阳性表达，CD10、P63表达均为阴性。结论：肾脏集合管癌的病理诊断主要依靠病理组织学形态，以及使用免疫组化进行排除性的鉴别诊断。
揹景與目的：腎髒集閤管癌少見，不足腎髒噁性腫瘤的1%，腫瘤侵襲性彊，超過50%的患者在首次診斷時已經髮生轉移。集閤管癌的診斷常很睏難，往往需要排除性診斷。本研究觀察腎髒集閤管癌的臨床病理學特點、免疫組化特徵，探討其病理診斷及鑒彆診斷。方法：收集5例腎髒集閤管癌的患者資料，進行病理組織學觀察，免疫組織化學染色(EnVision法)檢測CK19、CAM5.2、CK7、Vimentin、CD10、P63和PaX-8。結果：腎髒集閤管癌臨床癥狀以血尿、腹痛、腹塊為主；腫瘤主要起源于腎髒中央區的髓質，組織學以不規則的腺管狀或管狀乳頭狀結構，伴炎性纖維組織增生性間質為主要形態學錶現；免疫組化檢測結果顯示，5例腎髒集閤管患者中，CK19、CAM5.2、PaX-8均為暘性錶達，2例Vimentin存在暘性錶達、1例CK7暘性錶達，CD10、P63錶達均為陰性。結論：腎髒集閤管癌的病理診斷主要依靠病理組織學形態，以及使用免疫組化進行排除性的鑒彆診斷。
배경여목적：신장집합관암소견，불족신장악성종류적1%，종류침습성강，초과50%적환자재수차진단시이경발생전이。집합관암적진단상흔곤난，왕왕수요배제성진단。본연구관찰신장집합관암적림상병이학특점、면역조화특정，탐토기병리진단급감별진단。방법：수집5례신장집합관암적환자자료，진행병리조직학관찰，면역조직화학염색(EnVision법)검측CK19、CAM5.2、CK7、Vimentin、CD10、P63화PaX-8。결과：신장집합관암림상증상이혈뇨、복통、복괴위주；종류주요기원우신장중앙구적수질，조직학이불규칙적선관상혹관상유두상결구，반염성섬유조직증생성간질위주요형태학표현；면역조화검측결과현시，5례신장집합관환자중，CK19、CAM5.2、PaX-8균위양성표체，2례Vimentin존재양성표체、1례CK7양성표체，CD10、P63표체균위음성。결론：신장집합관암적병리진단주요의고병리조직학형태，이급사용면역조화진행배제성적감별진단。
Background and purpose: Collecting duct carcinomas of the kidney are a rare malignant tumor accounting for<1%of renal malignancies. It is associated with aggressive nature and more than 50%of patients have metastatic disease at the time of initial diagnosis. The diagnosis of collecting duct carcinoma is often dififcult and to some extent is one of exclusion. This study aimed to study the clinicopathologic features of collecting duct carcinoma of the kidney. Methods:We retrieved the data of ifve cases of collecting duct carcinomas of the kidney from pathology ifles, and determined the expressions of CK19, CAM5.2, CK7, Vimentin, CD10, P63 and PaX-8 by pathohistological observation and immunohistochemical examination. Results: The most common symptoms were blood urine, bellyache and abdomen mass. The tumor originated from the medulla of the kidney central zone. Histologically, the tumors demonstrated irregular tubular or papillary architecture with the stroma of inflammatory cells and fibrous tissue proliferation. Immunohistochemically, the tumor cells were positive for CK19(5/5), CAM5.2(5/5), PaX-8(5/5), Vimentin(2/5), CK7(1/5), and negative for P63, CD10. Conclusion: The correct diagnosis in collecting duct carcinomas of the kidney is based on characteristic morphological features and immunophenotype labeling.
